To Fix Health Care System, Put Consumers in Charge

Democrats were riding high in the polls in 2006 and 2008, and one of their big issues was health care. Then, after passing the president’s health care law, the politics shifted, and the issue helped sweep the GOP to victory in the 2010 midterm elections. A few months later, Republicans had a 14-point advantage in terms of voter trust on the health care issue.

Then, Wisconsin Rep. Paul Ryan introduced his health care plan, and the lead disappeared. Neither party has an advantage on the issue now.

President Obama’s plan is unpopular, and most want to see it repealed. Ryan’s plan is unpopular, and few want to see it enacted. Both plans are unpopular because neither one puts consumers in charge of their own health care decisions. More than anything else, that lack of consumer control is the root cause of the health care problems facing our nation today.

Americans now pay a smaller share of their disposable income on out-of-pocket medical care than they did in 1960. Nearly nine out of every 10 dollars spent on medical care coverage is paid by either an insurance company or the government. Since someone else is paying the bills, someone else ends up making the big decisions about things that affect every individual’s health care.

That is precisely what most Americans want to change. No one wants their health care choices being made by government officials, insurance companies or their employer. People want to make those important decisions themselves.

Putting consumers in charge would require pretty radical change, but it’s the type of change voters could support. For example, consider a fairly typical situation where a company provides health insurance coverage for its workers. Rather than letting the company choose the plan, 82 percent believe that each worker should be allowed to use that money to pick his or her own insurance plan. If that plan ends up costing less than the official company plan, most believe the worker should be allowed to keep the change.

But giving consumers control of the money doesn’t mean much unless they have a variety of competing insurance plans to consider. Three out of four voters think it’s time to end the antitrust exemption granted to health insurance companies. Why? By a three-to-one margin, voters believe that increased competition among insurance companies would do more to reduce costs than increased government regulation.

Voters also want to reign in the government bureaucrats. Rather than letting the government define a one-size-fits-all insurance plan, 77 percent think individuals should have the right to choose between plans with a mix of higher deductibles and lower premiums or the reverse. Seventy-eight percent believe everyone should have the choice between more expensive plans that cover every medical procedure and lower cost plans that cover only major medical procedures.

To insure adequate choices, voters overwhelmingly believe that everyone should be allowed to buy insurance policies across state lines and that everyone should be able to purchase the same insurance coverage provided for members of Congress. Recognizing the importance of consumer incentives, most also believe insurance companies should be allowed to offer discounts to those who take care of themselves by exercising, eating well and not smoking.

Putting consumers in charge threatens the status quo in Washington, but it will give Americans a more responsive, less expensive system of medical care.